高频振荡通气在重症胎粪吸入综合征患儿治疗中的应用

Application of High-frequency Oscillatory Ventilation in the Treatment of Severe Meconium Aspiration Syndrome in Neonates

【目的】评价高频振荡通气（HFOV）治疗新生儿重症胎粪吸入综合征（MAS）的疗效。【方法】对本院2008年9月至2011年6月38例重症MAS新生儿予HFOV治疗。观察HFOV治疗前后肺功能变化及病情转归。【结果138例中治愈31例（81．6％），放弃治疗7例。治疗1～2h后动脉氧分压（PaO2）由HFOV治疗前的（62．16±23．03）mmHg上升为（81．69±23．84）mm2Hg；吸氧体积分数（Fi02）由HFOV治疗1～2h的（0．48±0．14）降低为治疗24h后的（0．38±0．13）；PaO2／Fi02由（173．59±74．44）增加到（237．02±89．22）；动脉二氧化碳分压（PaCO2）由（48．95±12。11）mmHg下降到（41．89±12．69）mmHg，上述各指标前后比较其差异均有统计学意义（Pd0．05）。【结论】HFOV用于新生儿重症MAS疗效好，能较快改善肺氧合功能，改善预后。

[Objective]To evaluate the efficacy of high-frequency oscillation ventilation（HFOV） for the treatment of neonates with severe meconium aspiration syndrome （MAS）. [Methods]Thirty-eight neonates with severe MAS in our hospital from Sept. 2008 to June 2011 were given HFOV treatment. The changes of pulmonary function and the prognosis were observed before and after HFOV treatment. [Results]Among 38 patients, 31 patients（81.6%） were cured and 7 patients abandoned the therapy. After 1-2 h of treatment with HFOV, PaO2 increased from （62.16±23.03）mmHg to （81.69±23.84）mmHg, and FiO2 decreased from （0.48±0.14） 1-2h before HFOV to （0.38±0. 13） 24h after HFOV, and PaO2/FiO2 increased from （173.59±74. 44） to （237. 02d=89. 22）, and PaCO2 decreased from （48.95±12.11） mmHg to （41.89±12.69） mmHg. There were significant differences in above indexes before and after treatment（ P〈0.05）. [Conclusion]HFOV for the treatment of neonates with severe MAS has good efficacy, and can improve pulmonary function and prognosis.